Summary & Overview
CPT 64714: Open Lumbar Plexus Decompression (Neurolysis)
CPT code 64714 denotes an open neurolysis or decompression procedure targeting the lumbar plexus to release scar tissue or other compressive sources causing tension on lumbar nerves. This code is used for surgical cases in which direct visualization and incision of restrictive tissue are required to relieve neural compression affecting the upper leg and nearby regions. Nationally, procedures addressing lumbar plexus compression have implications for surgical specialty billing, facility utilization, and postoperative care pathways.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical framing of the code, typical sites of service (hospital OR and ambulatory surgery centers), and the service type categorized as open peripheral nerve decompression/neurolysis. The publication provides benchmarks where available, outlines common billing considerations and modifier usage, and summarizes relevant policy or coverage themes impacting payment and documentation practices. The content is intended to help coding professionals, surgical teams, and revenue cycle stakeholders understand the clinical purpose of CPT code 64714, its billing context, and areas to review for documentation and payer communications. Data not available in the input for specific payor rates, taxonomies, ICD-10 pairings, and related codes.
Billing Code Overview
CPT code 64714 describes an open surgical procedure to release scar tissue or other compressive structures that are exerting pressure on the lumbar plexus. The procedure involves incising and removing restrictive tissue to relieve tension on the nerve network that supplies the upper leg and adjacent areas.
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Service type: Open peripheral nerve decompression/neurolysis
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Typical site of service: Hospital operating room or ambulatory surgery center (inpatient or outpatient surgical setting)
Clinical & Coding Specifications
Clinical Context
A 46-year-old patient presents with progressive lateral thigh pain, numbness, and weakness following multiple lumbar spine surgeries and persistent scar formation. Conservative measures including physical therapy, analgesics, and epidural steroid injections have failed to relieve symptoms. Diagnostic workup includes focused neurologic exam, MRI showing postoperative scar and compression along the lumbar plexus region, and nerve conduction studies suggestive of entrapment. The surgical plan is an open neurolysis of the lumbar plexus to incise perineural scar tissue and release constrictive bands to relieve tension and restore nerve function. Typical workflow: preoperative evaluation with anesthesia assessment, informed consent emphasizing risks and benefits, operative localization with imaging, open incision and careful dissection to identify the lumbar plexus, microsurgical scar excision and decompression, hemostasis, layered closure, postoperative monitoring for neurologic status and wound care, and scheduled follow-up for rehabilitation and pain management. Typical setting is an inpatient or outpatient hospital operating room depending on comorbidities and anticipated complexity; procedures are performed by orthopedic spine surgeons, neurosurgeons, or peripheral nerve surgeons with perioperative support teams.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | Use when the procedure is performed on the right-sided lumbar plexus or right-sided approach. |